Healthcare Provider Details

I. General information

NPI: 1699806240
Provider Name (Legal Business Name): MURPHY-HARPST CHILDREN'S CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 FLETCHER ST
CEDARTOWN GA
30125-3249
US

IV. Provider business mailing address

740 FLETCHER ST
CEDARTOWN GA
30125-3249
US

V. Phone/Fax

Practice location:
  • Phone: 770-748-1500
  • Fax: 770-749-1094
Mailing address:
  • Phone: 770-748-1500
  • Fax: 770-749-1094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCCI-10006
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number115-624-D
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License NumberCCI-10006
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License NumberCCI001408
License Number StateGA

VIII. Authorized Official

Name: MS. JOANNE SIMMONS
Title or Position: CEO, PRESIDENT
Credential:
Phone: 770-748-1500